Kornimate/medical-research-clean huggingface dataset:
qualitative evaluation of therapeutic alliance in adolescent psychiatry

Conditions: Anorexia Nervosa; Depression; School Phobia

Summary: context: psychiatric disorders (anorexia nervosa, depression, anxiety based school refusal) are a major public health concern in adolescence. their treatment is a challenge for the families, the health care system and society. the treatment is complex and non-standardized. in clinical practice, the relational dimension between the stakeholders is recognized by all. nevertheless no study has ever crossed their perspectives about therapeutic alliance in adolescent psychiatry. objective: to explore, within a qualitative approach, how a therapeutic alliance is established in three different clinical situations according to the adolescents, their parents and their physicians by crossing their perspectives. methods: this is a national (france) multi-center qualitative study based on 180 semi-structured interviews. participants (purposively selected until data saturation) came from three different sub-samples: (i) adolescents with anorexia nervosa (n =20) plus their parents (n=20) and their physicians (n=20), (ii) adolescents with depressions (n=20) plus their parents (n=20) and their physicians (n=20), and (iii) adolescents with anxiety-based school refusal (n=20) plus their parents (n=20) and their physicians (n=20). data are collected through open ended semi structured interviews and independently analyzed with nvivo v.11 software by three researchers according to the principles of interpretative phenomenological analysis.


Eligibility criteria:
inclusion criteria: * adolescents, boys and girls, aged 12 to 18 years, speaking fluent french, with (i) anorexia nervosa according to dsm 5 criteria (ii) depressive disorders (dysthymia, depressive episode) according to dsm 5 criteria (iii) anxiety-based school refusal according to four criteria: 1. refusal to attend school (to operationalize this first criterion, adolescents were included if they had not attended school at all for at least one month before starting treatment); (2) presence of a dsm-5 anxiety disorder (except obsessive-compulsive or post-traumatic stress disorders) with emotional upset at the prospect of attending school; (3) absence of a dsm-5 conduct disorder; and (4) parental knowledge of the adolescent's whereabouts during the period of non-attendance. that led to treatment that had begun at least six months earlier and clinically determined to be well enough to participate in a research interview. * receiving treatment for at least 6 months * one parent at least agrees to participate exclusion criteria: * acute symptoms and serious somatic and/or psychiatric co-morbidities
causes, analysis of the sub-evaluating coronary syndromes acute and disparities in france in women

Conditions: Coronary Acute Syndrome

Summary: despite efforts of learned societies, community cardiology and more generally of most players in the health, cardiovascular diseases continue to be the leading cause of death among women in france and all over the western world, there where they fell to second place among men. clinical practice and the disparity between the sexes are still insufficiently known. multicenter observational study on a cross-week comparative basis with men

in france, as in other industrialized countries, ischemic heart disease is a major cause of morbidity and mortality in women. work to improve epidemiological knowledge, prevention, screening, risk stratification and treatment of ischemic heart disease in women has a potential impact on all the issues listed. there is therefore a double challenge: * a public health issue to alert the female population on cardiovascular risk and its consequences, while the female population does not feel concerned by the potential danger. * a challenge for health professionals so that they have the same thing vis-à-vis the cardiovascular prevention among women and whatever their field of practice.

Eligibility criteria:
inclusion criteria: * women all patients and / or men regardless of age * admitted to a cardiology department (in the intensive care unit or cardiology traditional) week of the survey, * having presented an acute coronary syndrome, regardless of the type with or without st segment above, with or without elevated troponin, complicated or not, regardless of its support invasive or conservative, * patients who agreed to participate in the study.
the theranostic value of stard3 in colorectal cancer: the star study

Conditions: Colorectal Cancer

Summary: this study aims at verifying the overexpression of stard3 in both early and advanced crc patients derived tissues, to identify the pathways underpinning tumorigenesis and cancer progression in which stard3 is involved. moreover its role as a dynamic biomarker of treatment response and its part in treatment sensitivity will be explored.

colorectal cancer (crc) is one of the most prevalent and deadly tumours in both men and women worldwide. an rnai screening on 214 potential oncogenes described by the tcga was performed and stard3 was identified as potential theranostic target in mcrc. considering the effects on cell viability and the druggability, stard3 represents a strong candidate as a valid diagnostic and therapeutic target for mcrc patients. in recent years, organoids have become a research hotspot, showing a significant potential in the biological analysis of tumours. patient derived organoids could be a viable platform to test clinically available drugs and/or promising new molecules to explore tumour sensitivity in an ex-vivo model. this is a longitudinal observational study on crc patients derived tissues to verify the overexpression of stard3 in both early and advanced crc patients, to identify the pathways underpinning tumorigenesis and cancer progression in which stard3 is involved through the development of cancer derived organoids, to explore its role as a dynamic biomarker of treatment response and to demonstrate its part in treatment sensitivity measured in tumour derived organoids compared to drug sensitivity observed in real-world patients.

Eligibility criteria:
inclusion criteria: * histologically confirmed diagnosis of colorectal cancer, independently from diagnosis stage. * age ≥18 years. * signed informed consent form. * availability of tissue and blood samples stored at the institutional biobank for research purposes. exclusion criteria: * patients for which the tumour biobanking process could compromise the diagnostic assessments. * pregnancy or breast-feeding. * history of concomitant or previous malignancy in the previous 5 years, except for adequately treated cutaneous squamous cell carcinoma or surgically removed in situ cervical carcinoma.
outpatient preoperative parenteral nutrition in malnourished surgical patients

Conditions: Malnutrition; Surgery

Summary: malnutrition is common in surgical patients. many studies have shown a clear association between malnutrition and poor surgical outcomes. parenteral nutrition (pn) is a nutrition intervention that is given by vein and can be safely provided to malnourished patients. it contains carbohydrates, fats, and protein just like you would normally in your diet. pre-operative pn is able to improve outcomes in surgical patients. however, pre-operative pn has traditionally required hospital admission which results in increased length of stay, hospital cost, and hospital-acquired infection. moreover, in hospital pre-operative pn may not be feasible or prioritized when access to inpatient surgery beds is limited. outpatient pn provides the opportunity to solve this problem. the feasibility and impact of outpatient pn in malnourished patients undergoing major surgery have not previously been studied. this study aims to evaluate the feasibility of outpatient pre-operative pn and its effect on patient's outcomes.


Eligibility criteria:
inclusion criteria: 1. patients 18 years of age or older 2. patients screened at risk of malnutrition by canadian nutrition screening tool (cnst) and identified as malnourished by subjective global assessment (sga) b or c exclusion criteria: 1. patients undergoing minor or laparoscopic surgery 2. pregnancy 3. patients with severe systemic diseases defined by american society of anesthesiologists (asa) classification iii to v 4. patients with diabetes mellitus 5. patients with planned palliative treatment
management of tick-borne encephalitis

Conditions: Infectious Encephalitis

Summary: in this retrospective cohort study of patients with tick-borne encephalitis (tbe), potential differences in the clinical presentation at admission and diagnostic and therapeutic management of patients with tbe initially referred to infectious diseases or neurology departments were assessed. associations between severity of acute illness and clinical outcome were also explored.


Eligibility criteria:
inclusion criteria: * microbiologically confirmed tick-borne meningoencephalitis exclusion criteria: * exchanged between id and neurology within the first 48 hours due to organizational constraints * transferred from another hospital * lumbar puncture not performed * not fulfilling study criteria

Keywords: tick-borne encephalitis outcome neuroimaging lumbar puncture clinical management
relationship between plasma metabolome and the efficacy of systemic glucocorticoid in aecopd

Conditions: COPD; COPD Exacerbation Acute

Summary: acute exacerbation of chronic obstructive pulmonary disease (aecopd) significantly increases the mortality of the patients with copd. guidelines have recommended systemic glucocorticoid as regular treatment. recently, evidences have shown that systemic glucocorticoid cannot not be benefit to all of the patients with aecopd. thus the problem that how the clinicians can screen the patients who can benefit from systemic glucocorticoid needs to be solved urgently.

acute exacerbation of chronic obstructive pulmonary disease (aecopd) significantly increases the mortality of the patients with copd. guidelines have recommended systemic glucocorticoid as regular treatment. recently, evidences have shown that systemic glucocorticoid cannot not be benefit to all of the patients with aecopd. thus the problem that how the clinicians can screen the patients who can benefit from systemic glucocorticoid needs to be solved urgently. a previous study found that plasma metabolome changed significantly after dexamethasone treatment in health participants. furthermore, inter-person variability was high and remained uninfluenced by treatment, suggesting the potential of metabolomics for predicting the efficacy and side effects of systemic glucocorticoid. our previous study found that serum metabolites profile in copd patients differed from that in controls. therefore, the investigators hypothesized that metabolome changes in patients with aecopd may be associated with the efficacy of systemic glucocorticoid. in this study, the investigators will utilize ultraperformance liquid chromatography / mass spectrometry (lc-ms) and gas chromatography / mass spectrometry (gc-ms) methods for analysis of the metabolites in aecopd patients and compare the metabolites profiles between patients with systemic glucocorticoid treatment success and treatment failure. the investigators aim to detect the metabolic biomarkers and metabolic pathways which are related to efficacy of systemic glucocorticoid and contribute to the precise treatment of copd.

Eligibility criteria:
inclusion criteria: * patients who meet the diagnostic criteria for acute exacerbation of chronic obstructive pulmonary disease in gold 2016 and require hospitalization. exclusion criteria: * bronchial asthma, bronchiectasis and other airflow obstructive diseases; * combined with community-acquired pneumonia, hospital-acquired pneumonia or aspiration pneumonia; * combined with severe liver and kidney insufficiency; * malignant tumor; * immune deficiency due to chemotherapy or hiv infection; * received systemic hormone therapy due to acute exacerbation of chronic obstructive pulmonary disease within 1 month before this admission; * severe trauma or stress, etc.
minnesota retain impact evaluation

Conditions: Any Injury or Illness Acutely Impacting Work

Summary: this study is a randomized control trial (rct) to evaluate the impact of retain program expansion and services on workforce retention and reduction of future workplace disability in the state of mn. collaboration between partners to implement best practices in early intervention to support injured or ill employees in stay at work and return to work will be implemented.

mn retain is a collaborative program led by the minnesota department of employment and economic development (deed), minnesota department of health (mdh), department of labor and industry (dli), mayo clinic, and workforce development inc (wdi) and includes stakeholders throughout mn.

Eligibility criteria:
inclusion criteria: * must have been unable to work for no more than 6 months prior enrollment; 80% of participants must be within 3 months of their last day of work * 18 years or older * minnesota resident * works in minnesota * employed or currently in the labor force * meets one of the following: 1. diagnosis of a work related or personal injury or illness that impacts employment 2. invasive procedure (e.g., surgery) within the past 12-weeks or anticipated within the next 8-weeks that impacts employment exclusion criteria: * legal representation/litigation at the time of enrollment related to their medical condition. * does not have the capacity to give appropriate informed consent * employed by a retain healthcare recipient or subrecipient with an existing return to work program for employees (i.e. mayo clinic employees) * worker's compensation recipients that have a qualified rehabilitation consultant (qrc) or a disability case manager (dcm)

Keywords: retain minnesota retain mn retain illness recovery injury recovery out of work help work placement assistance job help work help help keeping my job stay at work return to work
duration of dual anti-platelet therapy (dual-acs)

Conditions: Acute Coronary Syndrome; Coronary Artery Disease

Summary: despite substantial evidence supporting the use of dual anti-platelet therapy in patients with acute coronary syndrome, there remains major uncertainty regarding the optimal duration of therapy. recent evidence suggests that shorter durations of dual anti-platelet therapy are superior because the avoidance of atherothrombotic events is counterbalanced by the greater risks of excess major bleeding with apparent increases in all-cause mortality with longer durations. we here propose an international randomised controlled trial of 18,318 patients with type 1 myocardial infarction allocated to differing durations of dual anti-platelet therapy. we will use electronic health record linkage to track duration of therapy and clinical outcomes in a real-world, real-time, efficient and highly cost-effective trial. this has the potential to define treatment duration, settle a major outstanding international controversy, and influence modern cardiology practice across the world.


Eligibility criteria:
inclusion criteria: * aged ≥18 years * clinical diagnosis of type 1 myocardial infarction within 12 weeks * in the opinion of the attending clinician requires dual anti-platelet therapy with aspirin and a p2y12 receptor antagonist * resident in the country of recruitment with their unique health identifier * the attending clinician has equipoise regarding the duration of therapy * provision of informed consent exclusion criteria: * clear indication for specific duration of dual anti-platelet therapy * type 2 myocardial infarction * contraindication to aspirin or p2y12 receptor antagonist * non-resident in the country of recruitment * previous recruitment into the trial * inability or unwilling to give informed consent
il-6 regulation of energy stores during recovery from an acute exercise bout

Conditions: Glycogen Depletion

Summary: the aim of the study is to investigate the role of exercise-induced il-6 in regulating energy stores and energy metabolism during recovery after an acute exercise bout. to achieve this, 30 men will be randomized to infusion placebo or tocilizumab (il-6 receptor antibody) combined with a 2-hour exercise bout. stable isotope tracers will be infused to determine substrate kinetics. indirect calorimetry will be applied to determine substrate oxidation, and muscle biopsies will be taken to determine substrate uptake and storage.


Eligibility criteria:
inclusion criteria: * physically active (defined as meeting the acsm's guidelines of 2.5h per week of moderate to vigorous physical activity per week), young, healthy males will be included. participants may be included in the study if they meet all the following criteria: * age ≥ 18 years and ≤ 40 years * bmi \ 25 kg/m2 * healthy (based on screening) * stable body weight for 6 months * ≥ 2.5h/week moderate to vigorous physical activity exclusion criteria: * • cardiovascular disease * rheumatologic disease * metabolic disease * elite sports or high aerobic training status (vo2max \> 60 ml o2/min/kg) * frequent/chronic use of medications affecting physical performance or inflammation (nsaids, dmards, corticosteroids) * aspirin use \>100 mg/d * thyroid disease * current infection * aspartate amino transferase (ast) or alanine amino transferase (alt) \>2x upper normal range * history of carcinoma * history of tuberculosis * ketogenic diet * smoking * anemia (hematocrit \<33%) * neutrophil count \<0,5x 109/l * thrombocytes \<50x 109/l or bleeding disorders
pre-operative carbohydrates in diabetic patients undergoing cabg

Conditions: Insulin Resistance; Diabetes Mellitus, Type 2; Coronary Artery Bypass Surgery

Summary: preoperative carbohydrates (cho) supplement has been shown to alleviate postoperative insulin resistance (ir) in nondiabetic patients undergoing a variety of surgeries. however, it remains controversial whether preoperative cho could yield similar effects in diabetic patients. thus, the investigators design a randomized controlled trial investigating the impact of preoperative cho on postoperative ir and clinical outcomes in diabetic patients undergoing cardiac surgery. the results of the study may give some clinical implications and further improve perioperative care for diabetic patients.

cho supplement has been widely investigated in nondiabetic patients undergoing various surgeries. it has been proved that preoperative cho could alleviate postoperative insulin resistance (ir) and improve patients' well-being in nondiabetic patients. however, whether preoperative cho could yield similar effects in diabetic patients remains controversial. till now, seldom has the administration of preoperative cho been investigated in diabetic patients and few studies reported ir and postoperative recovery of diabetic patients undergoing cardiac surgery. the investigators present a prospective, single-center, single-blind, randomized, no-treatment controlled trial of preoperative cho on diabetic patients undergoing off-pump coronary artery bypass grafting (opcab). a total of 62 patients will be enrolled and randomized to either group cho or group control (ctrl). patients in group cho will receive cho fluid containing 50 g of carbohydrates the evening before surgery (20:00-24:00) while their counterparts in group ctrl will be fasted after 20:00 the evening before surgery. the primary endpoints are postoperative insulin resistance (ir) assessed via homeostasis model assessment (homa). the secondary endpoints are the potential mediators relating to ir including inflammatory factors and stress reactions assessed by serum cortisol. exploratory endpoints are in-hospital clinical endpoints.

Eligibility criteria:
inclusion criteria: 1. previously diagnosed t2dm 2. diagnosed with cad with coronary angiography and indicated for opcab 3. age between 18 and 75 years old 4. first operation in the morning and anesthesia induced around 8:00 5. written informed consent by the patients exclusion criteria: 1. combined with other heart diseases or vascular malformations that require surgery in addition to opcab 2. presence of symptoms or signs of heart failure such as orthopnea, distended jugular vein, lower extremity edema, etc. 3. reduced lvef (lower than 50%) 4. combined with gastroesophageal reflux 5. combined with thyroid insufficiency requiring replacement therapy with levothyroxine 6. combined with adrenal insufficiency requiring replacement therapy with corticosteroids 7. refuse to participate.

Keywords: preoperative carbohydrates diabetes mellitus off-pump coronary artery bypass grafting insulin resistance
iressa in combination with cisplatin & radiotherapy in patients with advanced head & neck carcinoma

Conditions: Cancer of Head and Neck

Summary: · to evaluate the disease free survival rate at 2 years of patients with advanced head and neck carcinoma treated with zd1839 250 mg administered once daily in combination with cisplatin and a standard course of radiotherapy.


Eligibility criteria:
inclusion criteria: 1. histologically confirmed squamous head and neck carcinoma 2. extra-laryngeal tumour or laryngeal tumour that is inoperable (not resectable) considered by head and neck cancer committee 3. stage iii-iv (iva and ivb) disease 4. measurable disease according to recist criteria 5. aged 18 years or older 6. eastern cooperative oncology group (ecog) performance status (ps) 0-1 7. normal renal, haematological (neutrophils \>1´5 x 109/ l and platelets \> 100 x 109/l) and liver function exclusion criteria: * 1. previous treatment for initial disease (neck dissection in n3 is allowed) 2. other co-existing malignancies or malignancies diagnosed within the last 5 years with the exception of basal cell carcinoma or cervical cancer in situ 3. incomplete healing from previous oncologic or other surgery 4. absolute neutrophil count (anc) less than 1.5 x 109/ l, or platelets less than 100x 109/l 5. serum bilirubin greater than 1.25 times the upper limit of reference range (ulrr) 6. in the opinion of the investigator, any evidence of severe or uncontrolled systemic disease (e.g. unstable or uncompensated respiratory, cardiac, hepatic or renal disease) 7. serum creatinine greater than 1.25 times the ulrr 8. alt or ast greater than 2.5 times the ulrr 9. evidence of any other significant clinical disorder or laboratory finding that makes it undesirable for the patient to participate in the trial 10. active dermatoses (e.g. psoriasis, eczema) 11. corneal abnormalities (other than scars, congenital abnormality or corneal tear film), history of dry eye syndrome or ocular surface diseases and neurological disorders 12. concomitant use of phenytoin, carbamazepine, barbiturates, rifampicin or drugs with known corneal toxicity 13. pregnancy or breastfeeding (women of child-bearing potential) 14. patient incapacity to reliably follow the treatment or follow up for family, economic or geographical reasons.

Keywords: head and neck cancer disease head cancer neck cancer cancer of head cancer of neck cancer of the head cancer of the head and neck cancer of the neck neoplasms, head and neck